Risk factors for early progression of diffuse low-grade glioma in adults

• Published in: Chinese neurosurgical journal 2022-10, Vol.8 (1), p.1-25, Article 25
• Main Authors: Wang, Long, Li, Xuegang, Chen, Tunan, Zhang, Chao, Shi, Jiantao, Feng, Hua, Li, Fei
• Format: Article
• Language: English
• Subjects: Brain cancer; Chemotherapy; Early progression; Glioma; Low-grade glioma; Multivariate analysis; Patients; Radiation therapy; Risk factors; Spinal cord; Statistical analysis; Surgery; Survival analysis; Tumors
• ISSN: 2057-4967; 2095-9370; 2057-4967
• DOI: 10.1186/s41016-022-00295-z

Background To explore the risk factors for early progression of diffuse low-grade glioma in adults. Methods A retrospective analysis of pathologic and clinical data of patients diagnosed with diffuse low-grade gliomas at Southwest Hospital between January 2010 and December 2014. The progression-free survival (PFS) less than 60 months was classified as the early progress group, and the PFS greater than 60 months was the control group for comparative analysis. Results A total of 138 patients were included in this study, including 94 cases of astrocytoma and 44 cases of oligodendroglioma. There were 63 cases with 100% resection, 56 cases with 90–100% resection degree, and 19 cases with resection degree < 90%. The average follow-up time was 60 months, of which 80 patients progressed and 58 patients did not progress. The average progression-free survival was 61 months. The median progression-free survival was 60 months. There were 68 patients with PFS ≤ 60 months and 70 patients with PFS > 60 months. The two groups were compared for statistical analysis. In univariate analysis, there were significant differences in tumor subtype (p = 0.005), range (p = 0.011), volume (p = 0.005), location (p = 0.000), and extent of resection (p = 0.000). Multifactor analysis shows tumor location (HR = 4.549, 95% CI: 1.324–15.634, p = 0.016) and tumor subtype (HR = 3.347, 95% CI = 1.373–8.157, p = 0.008), and imcomplete resection is factors influencing early progression of low-grade glioma. Conclusions Low-grade gliomas involving deep location such as basal ganglia, inner capsule, and corpus callosum are more likely to progress early, while incomplete resection is a risk factor in early progression of astrocytoma.